Hyperacusis: Difference between revisions

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*Depending on the extent of the disease progression at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.  
*Depending on the extent of the disease progression at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.  
*Patients with hyperacusis have profound psychological influence, patients presenting with self-harm or suicidal ideation<ref name="pmid29488875">{{cite journal| author=Aazh H, Moore BCJ| title=Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis. | journal=J Am Acad Audiol | year= 2018 | volume= 29 | issue= 3 | pages= 255-261 | pmid=29488875 | doi=10.3766/jaaa.16181 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29488875  }} </ref>.
*Patients with hyperacusis have profound psychological influence, patients presenting with self-harm or suicidal ideation<ref name="pmid29488875">{{cite journal| author=Aazh H, Moore BCJ| title=Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis. | journal=J Am Acad Audiol | year= 2018 | volume= 29 | issue= 3 | pages= 255-261 | pmid=29488875 | doi=10.3766/jaaa.16181 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29488875  }} </ref>.
==Clinical Features==
In the case of a [[hyperacusis]], patients can present with<ref name="pmid25104073">{{cite journal| author=Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N | display-authors=etal| title=A review of hyperacusis and future directions: part I. Definitions and manifestations. | journal=Am J Audiol | year= 2014 | volume= 23 | issue= 4 | pages= 402-19 | pmid=25104073 | doi=10.1044/2014_AJA-14-0010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25104073  }} </ref><ref name="pmid27569405">{{cite journal| author=Paulin J, Andersson L, Nordin S| title=Characteristics of hyperacusis in the general population. | journal=Noise Health | year= 2016 | volume= 18 | issue= 83 | pages= 178-84 | pmid=27569405 | doi=10.4103/1463-1741.189244 | pmc=5187659 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27569405  }} </ref>.
*[[Ear pain]]
*[[Annoyance]]
*[[Fear]]
*General intolerance to many sounds
*[[Crying spells]]
*[[Panic attacks]]
*[[Tinnitus]]
*[[Anxiety]]
*[[Stress]]
*[[Phonophobia]]
*[[Avoidant behavior]]
*[[Dizziness]]
*[[Nausea]]


==Treatment==
==Treatment==

Revision as of 04:42, 14 August 2020

Overview

Hyperacusis is a condition characterized by an over-sensitivity to a specific frequency of sound or intolerance to reasonable environmental sounds. A person with hyperacusis has difficulty accepting everyday sounds; some sounds may seem offensively loud to that person but not to others. In hyperacusis, a person gives inappropriate or exaggerated responses to sounds that are neither uncomfortable nor threatening loud to an average person; even low-intensity sounds can elicit the reaction[1][2].

Classification

Based on the symptoms, hyperacusis may be classified as Cochlear and vestibular hyperacusis[3][4][5].

1) Cochlear hyperacusis: (the most common form of hyperacusis) presents with ear pain, annoyance, and general intolerance to any sounds that most people don't notice or consider unpleasant. Crying spells or panic attacks may result from cochlear hyperacusis. As many as 86% of hyperacusis sufferers also have tinnitus.

2) Vestibular hyperacusis: The sufferer may experience dizziness, nausea, or a loss of balance when certain pitched sounds are present.

Anxiety, stress, and phonophobia may be present in both types of hyperacusis. Someone with either form of hyperacusis may develop avoidant behavior to avoid a stressful sound situation or avoid embarrassing themself in a social case that might involve noise.

Pathophysiology

Hyperacusis can be developed because of damage to the inner ear or hearing apparatus, affecting efferent part of the auditory nerve, and fibers that come out from the brain that control sounds. In this process, tissues of the auditory nerve are damaged, though the hair cells that permit us to hear pure tones remain integral. It can be as a result of injury to the neurological system of the brain. In some cases, hyperacusis may be triggered by a vestibular disorder. Stapes hypermobility can also be one of the causes of peripheral hyperacusis. Situations that comprise paralysis of the facial nerve (i.e., Ramsay-Hunt syndrome, Bell’s palsy, and Lyme disease) are involved in the causes of the condition.Hyperacusis increases in extent during anxiety, tiredness, or stress. The mechanism involved during stress, include endogenous dynorphins release into the synaptic region underneath inner hair cells. It potentiates the neurotransmitter glutamate, triggering sound to be seeming with excessive noise[6][7][4][1].

Causes

The Common causes of hyperacusis include[8][9][9][10][2]:

  • Loud noise experience.
  • Recreational and industrial noise acquaintance and noise-related hearing loss.
  • Expert musicians specifically those playing rock music and exposed to extended periods of amplified sound.
  • Other causes that can lead to hyperacusis include migraine, Lyme disease, psychiatric illness such as post-traumatic stress disorder, and Williams syndrome.
  • The most common cause of hyperacusis is overexposure to excessively high decibel levels (or sound pressure levels).
  • Some come down with hyperacusis suddenly by firing a gun, having an airbag deploy in their car, taking ear sensitive drugs.

Other causes can be due to the following:

Differentiating hyperacusis from other diseases

On the basis of sign and symptoms hyperacusis must be differentiated from misphonia, phonophobia, tinnitus, william syndrome,lyme disease,migraine[11][3][12][13].

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Negative emotional reaction Ringing in the ears Psychiatric disorders Hearing loss Sound sensitivity Loudness discomfort level
Misphonia + - + +/- - - Limbic system involved Clinical diagnosis
Phonophobia + - + +/- - - Limbic system involved Clinical diagnosis
Tinnitus +/- + + - + + 8th cranial nerve palsy/ auditory system involved Audiological exam
William Syndrome +/- - +/- + + + Genetic disorder Micro-array analysis/FISH and audiological exam
Lyme Disease + + +/- + + + Auditory system involved Audiological exam
Migraine - + - - + +/- Trigeminal ganglion stimulation Clinical diagnosis

Epidemiology and Demographics

Incidence

  • The incidence of hyperacusis is approximately 1 in 50,000 people.

Prevalence

Age

  • Hyperacusis is commonly seen in individuals with any age group.

Gender

  • Hyperacusis affects men and women equally.

Race

  • There is no racial predilection to hyperacusis.

Natural History, Complications, and Prognosis

Natural History

Complications

  • Common complications of hyperacusis depend on the etiology.

Prognosis

  • Depending on the extent of the disease progression at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.
  • Patients with hyperacusis have profound psychological influence, patients presenting with self-harm or suicidal ideation[17].

Treatment

The most common treatment for hyperacusis is retraining therapy which uses broadband noise. Tinnitus Retraining Therapy (TRT), a treatment originally used to treat tinnitus, uses broadband noise to treat hyperacusis. Pink noise can also be used to treat hyperacusis. By listening to broadband noise at soft levels for a disciplined period of time each day, patients can rebuild (i.e., re-establish) their tolerances to sound. When seeking treatment, it is important that the physician determine the patient's Loudness Discomfort Levels (LDL) so that hearing tests (brainstem auditory evoke response) or other diagnostic tests which involve loud noise (MRI) do not worsen the patient's tolerance to sound.

People

See also

External links

Template:Diseases of the ear and mastoid process he:היפראקוזיס nl:Hyperacusis fi:Hyperakusia Template:WikiDoc Sources

  1. ↑ 1.0 1.1 Vernon JA (1987). "Pathophysiology of tinnitus: a special case--hyperacusis and a proposed treatment". Am J Otol. 8 (3): 201–2. PMID 3631220.
  2. ↑ 2.0 2.1 Klein AJ, Armstrong BL, Greer MK, Brown FR (1990). "Hyperacusis and otitis media in individuals with Williams syndrome". J Speech Hear Disord. 55 (2): 339–44. doi:10.1044/jshd.5502.339. PMID 2329796.
  3. ↑ 3.0 3.1 Baguley DM (2003). "Hyperacusis". J R Soc Med. 96 (12): 582–5. doi:10.1258/jrsm.96.12.582. PMC 539655. PMID 14645606.
  4. ↑ 4.0 4.1 Baguley DM, Axon P, Winter IM, Moffat DA (2002). "The effect of vestibular nerve section upon tinnitus". Clin Otolaryngol Allied Sci. 27 (4): 219–26. doi:10.1046/j.1365-2273.2002.00566.x. PMID 12169120.
  5. ↑ Scharf B, Magnan J, Chays A (1997). "On the role of the olivocochlear bundle in hearing: 16 case studies". Hear Res. 103 (1–2): 101–22. doi:10.1016/s0378-5955(96)00168-2. PMID 9007578.
  6. ↑ Katzenell U, Segal S (2001). "Hyperacusis: review and clinical guidelines". Otol Neurotol. 22 (3): 321–6, discussion 326-7. doi:10.1097/00129492-200105000-00009. PMID 11347634.
  7. ↑ Sahley TL, Nodar RH (2001). "A biochemical model of peripheral tinnitus". Hear Res. 152 (1–2): 43–54. doi:10.1016/s0378-5955(00)00235-5. PMID 11223280.
  8. ↑ 8.0 8.1 Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N; et al. (2014). "A review of hyperacusis and future directions: part I. Definitions and manifestations". Am J Audiol. 23 (4): 402–19. doi:10.1044/2014_AJA-14-0010. PMID 25104073.
  9. ↑ 9.0 9.1 Di Stadio A, Dipietro L, Ricci G, Della Volpe A, Minni A, Greco A; et al. (2018). "Hearing Loss, Tinnitus, Hyperacusis, and Diplacusis in Professional Musicians: A Systematic Review". Int J Environ Res Public Health. 15 (10). doi:10.3390/ijerph15102120. PMC 6209930. PMID 30261653.
  10. ↑ Halevi-Katz DN, Yaakobi E, Putter-Katz H (2015). "Exposure to music and noise-induced hearing loss (NIHL) among professional pop/rock/jazz musicians". Noise Health. 17 (76): 158–64. doi:10.4103/1463-1741.155848. PMC 4918652. PMID 25913555.
  11. ↑ Palumbo DB, Alsalman O, De Ridder D, Song JJ, Vanneste S (2018). "Misophonia and Potential Underlying Mechanisms: A Perspective". Front Psychol. 9: 953. doi:10.3389/fpsyg.2018.00953. PMC 6034066. PMID 30008683.
  12. ↑ Nields JA, Fallon BA, Jastreboff PJ (1999). "Carbamazepine in the treatment of Lyme disease-induced hyperacusis". J Neuropsychiatry Clin Neurosci. 11 (1): 97–9. doi:10.1176/jnp.11.1.97. PMID 9990563.
  13. ↑ Levitin DJ, Menon V, Schmitt JE, Eliez S, White CD, Glover GH; et al. (2003). "Neural correlates of auditory perception in Williams syndrome: an fMRI study". Neuroimage. 18 (1): 74–82. doi:10.1006/nimg.2002.1297. PMID 12507445.
  14. ↑ 14.0 14.1 Paulin J, Andersson L, Nordin S (2016). "Characteristics of hyperacusis in the general population". Noise Health. 18 (83): 178–84. doi:10.4103/1463-1741.189244. PMC 5187659. PMID 27569405.
  15. ↑ Rosing SN, Schmidt JH, Wedderkopp N, Baguley DM (2016). "Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review". BMJ Open. 6 (6): e010596. doi:10.1136/bmjopen-2015-010596. PMC 4893873. PMID 27259524.
  16. ↑ Andersson G, Lindvall N, Hursti T, Carlbring P (2002). "Hypersensitivity to sound (hyperacusis): a prevalence study conducted via the Internet and post". Int J Audiol. 41 (8): 545–54. doi:10.3109/14992020209056075. PMID 12477175.
  17. ↑ Aazh H, Moore BCJ (2018). "Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis". J Am Acad Audiol. 29 (3): 255–261. doi:10.3766/jaaa.16181. PMID 29488875.
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